Organization
PROFESSIONAL HEARING CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WARREN PERRINE CCC-A (PRESIDENT)
(912) 489-6422
Entity
Organization
Contact information
Practice address
106 PROCTOR ST, STATESBORO, GA 30458-1351
(912) 489-6422
(912) 489-5866
Mailing address
106 PROCTOR ST, STATESBORO, GA 30458-1351
(912) 489-6422
(912) 489-5866
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
GA003170
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000968965E
—
GA
Enumeration date
05/18/2006
Last updated
12/27/2012
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